Impact of the Liver on Peritoneal Transport

Previously, we developed a distributed model of plasma-peritoneal small solute diffusion for specific tissues surrounding the peritoneal cavity and related the transport coefficients to the mass transport coefficient (MTC) of the “peritoneal membrane” model. Based on this theoretical analysis, we calculated tissue-specific MTCs for sucrose from microvascular data in the literature and found that the MTC for the liver was five times the magnitude of other tissues. We hypothesized that the liver was potentially the most significant single transport organ during peritoneal dialysis. To test this hypothesis, we measured the mass transfer from the plasma to fluid contained in diffusion chambers, which were glued to one of four tissues surrounding the peritoneal cavity. We determined that the rate of small solute transport from the plasma to each diffusion chamber was similar for all four tissues. We calculated the MTC of the liver to be no greater than other visceral or parietal surfaces. We therefore disproved our hypothesis concerning the liver. We conclude that the importance of a particular tissue to plasma-peritoneal transport is primarily dependent on the surface area exposed to the dialysis solution.